Yu-Hsiang Kao 1 , Shiao-Chi Wu 2 Show Affiliations »
Abstract
BACKGROUND: Continuity of care (COC) is positively associated with health care outcomes. However, the effect of COC on the reduction of asthma-related emergency department (ED) visits among older asthmatic patients is not clearly understood. METHODS: We conducted a retrospective cohort study using the Taiwan nationwide health insurance claims database between 2004 and 2013. Patients aged 65 years with asthma during 2005 to 2011 were selected. The COC index (COCI) is used to measure the number of individual physicians a patient sees in the first year and we identified asthma-related ED visit in the subsequent year. Cox model was used to examine the hazard ratio (HR) between COC and an ED visit for asthma. RESULTS: Among a total of 3395 subjects, the overall mean COC was 0.73, and 48.5% of subjects had perfect COC (COCI = 1). After controlling for covariables, in the group of patients with low COC, the risk of having an asthma-related ED visit was higher compared with those with perfect COC (Adjusted HR, 2.11; 95% CI, 1.37-3.25). CONCLUSIONS: Elderly asthmatic patients with lower COC had a significantly higher likelihood of having asthma-related ED visits. © Copyright 2017 by the American Board of Family Medicine.
BACKGROUND: Continuity of care (COC) is positively associated with health care outcomes. However, the effect of COC on the reduction of asthma -related emergency department (ED) visits among older asthmatic patients is not clearly understood. METHODS: We conducted a retrospective cohort study using the Taiwan nationwide health insurance claims database between 2004 and 2013. Patients aged 65 years with asthma during 2005 to 2011 were selected. The COC index (COCI) is used to measure the number of individual physicians a patient sees in the first year and we identified asthma -related ED visit in the subsequent year. Cox model was used to examine the hazard ratio (HR) between COC and an ED visit for asthma . RESULTS: Among a total of 3395 subjects, the overall mean COC was 0.73, and 48.5% of subjects had perfect COC (COCI = 1). After controlling for covariables, in the group of patients with low COC, the risk of having an asthma -related ED visit was higher compared with those with perfect COC (Adjusted HR, 2.11; 95% CI, 1.37-3.25). CONCLUSIONS: Elderly asthmatic patients with lower COC had a significantly higher likelihood of having asthma -related ED visits. © Copyright 2017 by the American Board of Family Medicine.
Entities: Disease
Species
Keywords:
Ambulatory Care; Asthma; Continuity of Care; Emergency Departments; Retrospective Studies; Taiwan
Mesh： See more »
Year: 2017
PMID： 28484073 DOI： 10.3122/jabfm.2017.03.160285
Source DB: PubMed Journal: J Am Board Fam Med ISSN： 1557-2625 Impact factor: 2.657